Is Standard TRUS-Guided Prostate Biopsy the End of the Game?

Objective: Prostate cancer (PCa) remains a major cause of morbidity and mortality among men worldwide, and histopathologic tissue sampling plays a pivotal role in diagnosis. Although transrectal ultrasound–guided prostate needle biopsy (TRUS biopsy) has been the standard diagnostic technique for decades, its effectiveness has increasingly been questioned with the widespread adoption of cognitive and magnetic resonance imaging (MRI)–targeted biopsy techniques. The aim of this study wa to present the clinical outcomes and costs of TRUS-guided prostate biopsy performed in the clinic and to compare its costs with those of MRI-targeted biopsy. Materials and Methods: Data from 221 patients who underwent prostate biopsy were retrospectively analyzed. Patient comorbidities, prostate-specific antigen levels, digital rectal examination findings, histopathologic results, and biopsy-related costs were recorded. Cost data for MRI-targeted biopsy were obtained from 9 private hospitals located in different regions of the country. Results: Prostate cancer was detected in 40.3% (n = 89) of the 221 patients. Clinically significant PCa was identified in 29.9% (n = 66), whereas malignancy could not be excluded in 1.4% (n = 3). The mean cost of TRUS-guided prostate biopsy performed in the clinic was calculated as US $26.8. In contrast, based on data obtained from 9 hospitals, the reported mean cost of MRI-targeted biopsy was US $1449. Conclusion: Transrectal ultrasound–guided prostate needle biopsy remains an effectivemand highly cost-efficient diagnostic method in patients with suspected PCa. This technique may be particularly valuable in clinical settings where access to MRI-targeted biopsy is limited. Cite this article as: Benli E, Kadim N, Yüce A, Çırakoğlu A, Keleş M, Arslan A. Is standard TRUS-guided prostate biopsy the end of the game? Urol Res Pract. 2025;51(6): 237-241.